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01.
arXiv (CS.LG) 2026-06-15

MOSIC: Model-Agnostic Optimal Subgroup Identification with Multi-Constraint for Improved Reliability

arXiv:2504.20908v3 Announce Type: replace Abstract: Current subgroup identification methods typically follow a two-step approach: first estimate conditional average treatment effects and then apply thresholding or rule-based procedures to define subgroups. While intuitive, this decoupled approach fails to incorporate key constraints essential for real-world clinical decision-making, such as subgroup size and propensity overlap. These constraints operate on fundamentally different axes than CATE estimation and are not naturally accommodated within existing frameworks, thereby limiting the practical applicability of these methods. We propose a unified optimization framework that directly solves the primal constrained optimization problem to identify optimal subgroups. Our key innovation is a reformulation of the constrained primal problem as an unconstrained differentiable min-max objective, solved via a gradient descent-ascent algorithm. We theoretically establish that our solution converges to a feasible and locally optimal solution. Unlike threshold-based CATE methods that apply constraints as post-hoc filters, our approach enforces them directly during optimization. The framework is model-agnostic, compatible with a wide range of CATE estimators, and extensible to additional constraints like cost limits or fairness criteria. Extensive experiments on synthetic and real-world datasets demonstrate its effectiveness in identifying high-benefit subgroups while maintaining better satisfaction of constraints.

02.
arXiv (CS.AI) 2026-06-18

Reinforcement Learning Foundation Models Should Already Be A Thing

arXiv:2606.18812v1 Announce Type: cross Abstract: Foundation models for language and vision are powered by internet-scale data, while structured domains (tabular prediction, time-series forecasting, graph learning, reinforcement learning) are not. The substitute is synthetic data, which shifts the burden from collection to prior design. Such priors already exist for many structured tasks: TabPFN and its successors solve tabular classification with a transformer pretrained on a synthetic Bayesian prior. We make two points. First, reinforcement learning is the conspicuous gap: sampling a synthetic MDP is as feasible as sampling a synthetic tabular dataset, yet no in-context RL work treats prior design as a primary objective. Second, MDPs admit a fixed-size sufficient statistic, independent of the episodes observed and tabular in shape, which makes them directly amenable to the attention-based architectures used for tabular foundation models, with a policy head replacing the supervised target. Together these define the agenda for an RL foundation model. As a proof of concept, we train one model entirely on synthetic MDPs and show that, with no task-specific tuning, it solves held-out tabular benchmarks in context, both online and offline: online, in far fewer episodes than UCB-VI and tabular Q-learning, and offline, competitively with VI-LCB.

03.
arXiv (CS.AI) 2026-06-18

ProfiLLM: Utility-Aligned Agentic User Profiling for Industrial Ride-Hailing Dispatch

arXiv:2606.18803v1 Announce Type: new Abstract: Bringing Large Language Models (LLMs) into industrial ride-hailing dispatch as semantic feature extractors over platform-scale behavioral logs is a compelling but under-explored data systems problem. Production matching pipelines remain dominated by structured numerical features, yet decisive behavioral signals (e.g., a driver's habitual aversion to certain regions) are inherently contextual and naturally expressible as LLM-generated user profiles. However, scaling such profiling to a live, millisecond-latency dispatcher faces three intertwined constraints rarely addressed together: on a platform with millions of daily orders, logs exceed any LLM's context window by orders of magnitude; most users are long-tail, with too few interactions for per-user profiling; and surface-fluent profiles do not necessarily improve downstream prediction utility. We present ProfiLLM, an agentic LLM data pipeline that operationalizes utility-aligned user profiling for production matching systems through two modules. (1) Tool-Augmented Global Knowledge Mining equips an LLM agent with 27 analytical tools to mine platform-scale data, producing reusable global knowledge, adaptive user clustering rules, and region-level supply-demand priors. (2) Utility-Aligned Profile Exploration generates multiple candidate profiles per cluster, evaluates them via a lightweight downstream utility proxy, iteratively refines the best candidates and constructs preference pairs for DPO fine-tuning. Deployed on DiDi's production dispatcher, ProfiLLM achieves up to +6.14% relative AUC improvement in outcome prediction, up to +4.35% GMV gain in dispatching simulation, and consistent improvements in a 14-day online A/B test including +0.47% GMV, +0.33% Completion Rate, and -0.82% Cancel-Before-Accept rate.

04.
arXiv (CS.CV) 2026-06-16

Structure-aware Knowledge-guided Heterogeneous Mamba for Zygomaticomaxillary Suture Assessment

The Zygomaticomaxillary Suture is a key circummaxillary structure that connects the zygomatic bone and the maxilla, which serves as a primary site of resistance during maxillary advancement, and its maturation status directly influences the timing and efficacy of orthopedic interventions. However, accurate staging of ZMS maturation remains challenging due to subtle high-frequency transitions in suture lines and the global semantic ambiguity between adjacent stages. To address this, we present the first public ZMS dataset, comprising 3,790 ZMS images covering the entire age range from 4 to 24 years. Based on this dataset, we propose SKMamba, a Structure-aware and Knowledge-guided Mamba-based multi-modal framework for automated ZMS maturation assessment. SKMamba adopts a decoupled dual-path architecture that mimics the hierarchical diagnostic process used by experienced orthodontists. We first introduce an Implicit Edge Extractor (IEE), which leverages structural pre-training to reduce trabecular noise and accentuate sutural boundaries. Complementarily, a Cross-Modal Semantic Alignment (CSA) module is designed to incorporate anatomical descriptions from a large language model (LLM). This module helps align local morphological cues with global semantic descriptions while ensuring that objective morphological evidence remains the primary basis for decisions. Extensive experiments on our ZMS dataset demonstrate that SKMamba achieves state-of-the-art performance compared to existing methods. Code is available at https://github.com/galaxygxq1116/SKMamba.

05.
arXiv (CS.CV) 2026-06-15

TSA: Temporal Slot Activation for Persistent Object-Centric Video Representation

Unsupervised video object-centric learning aims to decompose dynamic scenes into temporally persistent entity representations. Existing recurrent video slot-attention methods propagate a fixed set of slots across frames, but typically assume unconditional slot propagation: every slot is updated and decoded at every frame, regardless of whether its corresponding object is visible. We show that this design violates a basic lifecycle requirement for persistent slots: when an object is absent or fully occluded, its slot should preserve its previous state and avoid explaining unrelated visible content. Instead, unconditional propagation creates two failure pathways: update-induced state drift, where current-frame evidence overwrites the absent object's representation, and decoder-induced reconstruction interference, where the inactive slot remains coupled to reconstruction through decoder attention. We propose Temporal Slot Activation (TSA), a mechanism that learns a per-slot, per-frame activation score $\alpha_{k,t} \in (0, 1)$ without visibility supervision. TSA uses this activation as a shared latent control variable for slot lifecycle modeling. When a slot is inactive, TSA anchors its state to the previous slot via activation-gated updating and suppresses its decoder participation through an activation-dependent additive bias on attention logits before softmax normalization. This jointly reduces state drift and reconstruction-driven interference. To improve decisions under partial occlusion and gradual reappearance, TSA further conditions activation prediction on a per-slot temporal memory produced by a Temporal Context Encoder. We evaluate TSA on MOVi-C/E, YT-VIS, and OVIS benchmarks using both standard and tracking-based metrics (FG-ARI, mBO, IDF1, HOTA). TSA consistently improves object decomposition and temporal identity preservation, with large gains on long, heavily occluded videos.

06.
arXiv (CS.CV) 2026-06-17

Seeing Is Not Screening: Multimodal Hidden Instruction Attacks on Agent Skill Scanners

Agent skills are emerging as an important attack surface in LLM-based systems. Through an empirical study of existing skill scanners, we find that current defenses primarily rely on textual descriptions, manifests, and source code as the main signals for security analysis, which can leave visually conveyed malicious intent insufficiently examined. This creates a practical blind spot: harmful operational instructions hidden in images may bypass scanning while still being recoverable by multimodal agents during deployment. To systematically investigate this threat, we propose SkillCamo, a document-mediated multimodal instruction attack that conceals malicious instructions within images bundled with a skill while rewriting the surrounding documentation to naturally reference those images as part of the normal workflow. Thus, the attack does not rely on the image alone, but on the joint interpretation of textual guidance and visual payload at execution time. To defend against such attacks, we further propose ExecScan, an execution-grounded multimodal scanning module that performs intent extraction, behavior reconstruction, abuse assessment, and deliberative execution simulation over skill artifacts. ExecScan jointly analyzes documentation, code, referenced resources, and visual content to recover hidden instructions, reconstruct executable behavior chains, and identify downstream risks such as exfiltration, destruction, persistence, deception, and privilege escalation. Extensive experiments show that image-hidden malicious instructions challenge existing skill scanners, while ExecScan can improve the skill scanning performance.

07.
arXiv (CS.AI) 2026-06-18

scGTN: Deep Siamese Graph Transformer Network for Single-cell RNA Sequencing Clustering

arXiv:2606.18672v1 Announce Type: cross Abstract: Single-cell RNA sequencing (scRNA-seq) serves a pivotal role in characterizing gene expression at the cellular level, enabling the identification of cell types and advancing the understanding of cellular heterogeneity. Despite the significant progress in scRNA-seq data clustering, we argue that current methods always ignore the sparsity and noise, as well as the complex intercellular structural information inherent in scRNA-seq data. Toward this end, in this paper, we propose a novel single-cell RNA-seq clustering framework via deep Siamese Graph Transformer Network (termed scGTN), which explicitly integrates gene expression profile and intercellular structural dependencies for cell clustering. In particular, we formulate scRNA-seq data as a graph and construct two augmented graph views that serve as dual views to capture complementary intercellular information. Then, a Siamese graph transformer network is employed to explicitly incorporate shortest-path information and node-wise distances for capturing richer structural relationships between cells. Finally, we employ an optimal transport strategy to guide the cell clustering in a self-supervised manner. Extensive experiments on multiple benchmark scRNA-seq datasets demonstrate that our scGTN consistently outperforms existing methods. Our code is available at https://github.com/W-RMSL/scGTN.

08.
arXiv (CS.CV) 2026-06-17

MaineCoon: Pursuing A Real-Time Audio-Visual Social World Model

As an increasing majority of global video content is consumed on social platforms for interactive social purposes, video generation models built for social worlds are important but largely overlooked by previous studies. In this work, we define the position of social world models and build a prototype model as the first step towards this goal. While previous world models successfully simulate physical environments or gaming world exploration, they remain fundamentally detached from human-centric social dynamics. To bridge this gap as the first step to social world models, we present MaineCoon, the first real-time audio-visual autoregressive model that has 22B parameters and is capable of real-time streaming generation and sub-second interaction, with a record-breaking frame rate of up to 47.5 FPS, on a single GPU. To the best of our knowledge, MaineCoon is also the first real-time audio-visual generation model specifically optimized for social-interactive applications. To enable efficient and stable training, we introduce several novel techniques into MaineCoon, including self-resampling, cross-modal representation alignment, domain-aware preference optimization, and reinforced online-policy distillation (ROPD). We also design the first agentic streaming inference framework that supports thousand-second-scale or even longer generation while mitigating drift with agentic cache management and prompt planing. These innovations significantly accelerate training while optimizing real-time inference performance. We believe this work not only sets a new state-of-the-art (SOTA) performance benchmark for high-quality, low-latency, and long-horizon audio-visual autoregressive models, but also points out the paradigm shift desired for next-generation AI-native social platforms.

09.
arXiv (CS.AI) 2026-06-18

Short-Term-to-Long-Term Memory Transfer for Knowledge Graphs under Partial Observability

arXiv:2605.22142v2 Announce Type: replace-cross Abstract: Reinforcement learning under partial observability requires deciding what information to retain, yet most memory-based approaches do not explicitly model short-term-to-long-term transfer of symbolic observations. We study this transfer process in a temporal knowledge-graph memory setting and cast it as a neuro-symbolic value-based decision problem: for each observed triple, the agent chooses whether to keep or drop it before long-term insertion. To handle variable-sized short-term buffers, we use a per-item Q-learning design with shared parameters and a practical temporal-difference update over matched items across consecutive steps. On the RoomKG benchmark at long-term memory capacity 128, learned transfer decisions outperform symbolic and neural baselines, including symbolic baselines with temporal annotations and history-based LSTM/Transformer baselines. Across transfer-policy ablations, a lightweight local short-term-only variant performs best, and step-level behavior shows that the policy keeps navigation- and query-relevant facts while discarding lower-value candidate facts, supporting explicit and interpretable memory decisions under memory constraints.

10.
arXiv (CS.AI) 2026-06-17

Statistical Foundations of LLM-based A/B Testing: A Surrogacy Framework for Human Causal Inference

arXiv:2606.17165v1 Announce Type: cross Abstract: Organizations and researchers show increasing interest in using large language models (LLMs) in place of human participants in A/B tests, in the hope of experimenting faster and at lower cost. We study when a treatment effect estimated on LLM outcomes recovers the effect that would have been measured on the human population of interest. Distributional equivalence between LLM and human outcomes would make any standard estimator valid but is unrealistic. We therefore develop a statistical framework that adapts surrogate endpoint theory to LLMs. The framework shows that calibrating LLM outcomes to human outcomes identifies the average treatment effect under surrogacy and comparability conditions that are jointly weaker than distributional equivalence. When these conditions fail, the effect of interest is only partially identified, and we provide diagnostics that can falsify surrogacy on historical experiments together with a bound on the worst-case bias from limited overlap. We further show that the stochasticity inherent to LLMs introduces both bias and variance, but using an average of multiple draws as the surrogate mitigates both. We illustrate the methods and theory in simulations and an application to A/B tests on Upworthy headlines. A central takeaway from our work is that the validity of LLM outcomes as surrogates can only be falsified for past treatments and never verified for new ones, so human experiments remain indispensable for novel interventions. We discuss the role of LLM choice, prompting, and temperature as design variables, and how to size human experiments for validation.

11.
arXiv (CS.CV) 2026-06-17

RAVA: Retrieval-Augmented Viewpoint Alignment for Subject-Driven Image Generation

Reference-driven image generation has made rapid progress on identity preservation, but reliable viewpoint control across different subjects remains poorly understood. The difficulty is not merely generating a new image of the target subject: the model must infer the implicit viewpoint of one subject and transfer it to another subject using only image-level evidence, without camera poses, depth, or ray-based conditions. In this setting, existing generators conditioned on multiple image references often rely on spurious semantic correlations, which lead to viewpoint drift, part-level structural mismatches, and missing or unsupported target-specific content. We formulate this challenge as cross-subject viewpoint alignment and propose RAVA, a retrieval-augmented framework that supplies explicit geometric evidence before generation. RAVA first learns a cross-instance viewpoint embedding that retrieves target-subject images aligned with the anchor viewpoint, then applies a LogDet-based subset selection strategy to retain a compact reference set that is both view-consistent and structurally complementary. The selected references are finally consumed by a fine-tuned multi-reference image generator. Experiments show that generic semantic embeddings are nearly random for this task, while the proposed retriever substantially improves viewpoint retrieval quality. On cross-subject generation, RAVA consistently outperforms zero-shot baselines and stronger retrieval alternatives under the same generation backbone. These results indicate that cross-subject viewpoint alignment benefits from retrieval-augmented geometric grounding rather than relying on end-to-end generation alone.

12.
arXiv (CS.CV) 2026-06-11

TextHOI-3D: Text-to-3D Hand-Object Interaction via Discrete Multi-View Generation and Joint Mesh Optimization

Text-conditioned 3D generation has progressed rapidly for images and isolated objects, but producing a hand-object mesh remains challenging: the output must preserve language semantics, cross-view consistency, object geometry, articulated hand shape, and physically plausible contact. We present TextHOI-3D, a staged framework that uses generated multi-view observations as an explicit interface between text-conditioned visual generation and geometry-aware hand-object recovery. TextHOI-3D learns a compact VQ token space for fixed-camera hand-object observations, predicts multi-view visual tokens from text with a CLIP-conditioned visual autoregressive model, and recovers a unified hand-object mesh through prior initialization, multi-view joint optimization, and anti-penetration refinement. The design separates semantic generation from geometric recovery while keeping both stages connected by a discrete multi-view representation. On HO3D-derived evaluations, the multi-view setting reduces object CD from 17.26 mm to 4.92 mm and penetration volume from 5.3721 cm^3 to 0.2193 cm^3 compared with a single-view counterpart, while improving hand errors and surface F-scores. These results support multi-view visual tokens as an effective intermediate representation for text-driven 3D hand-object mesh creation.

13.
Nature (Science) 2026-06-10

Deep learning four decades of human migration

Human migration is a fundamental driver of global demographic change, shaping population structure, labour markets and social policy across countries1–3. Although long-term migration patterns are often linked to economic development4, they can shift rapidly in response to shocks such as conflict, environmental crises and political change5. Despite its importance, migration remains difficult to measure consistently: existing data are sparse, concentrated in high-income settings and are fragmented across incompatible definitions, temporal resolutions and data types6–8. Past efforts have relied on partial datasets, including flow records, stock estimates and model-based reconstructions with limited coverage9–14. A central challenge is therefore to construct a globally consistent, high-resolution account of migration flows over time. Here we present a new dataset of annual origin-destination migration across 230 countries and regions from 1990 to the present, integrating diverse data sources into a unified modelling framework. By combining official statistics, census-based stocks, net migration estimates and past flow reconstructions, our approach produces temporally detailed and spatially comprehensive estimates that substantially extend existing resources. Using an ensemble of deep recurrent neural networks informed by geographic, economic, cultural and political covariates, we capture both persistent trends and short-term responses to changing conditions—all while propagating uncertainty to generate confidence bounds. Our results outperform existing five-year flow estimates on held-out data and provide finer temporal resolution, revealing previously obscured dynamics in global migration patterns. This framework highlights regions in which uncertainty remains high and data collection is most urgently needed. By releasing all data, code and trained models, we provide a transparent and reproducible foundation for future work. These advances enable a more timely and detailed understanding of human mobility, with implications for research and policy in an increasingly dynamic global system. A global annual migration-flow dataset (1990–2024) is produced using deep-learning models and diverse sources to estimate movements across 230 countries with improved temporal resolution, coverage and uncertainty estimates.

14.
arXiv (CS.CV) 2026-06-15

Pix2Fact: When Vision Is Not Enough – Benchmarking Fine-Grained VQA with Web Verification on High-Resolution Real-World Scenes

Despite progress on general tasks, vision-language models (VLMs) still struggle with challenges that demand both fine-grained visual grounding and external knowledge, a synergy overlooked by existing benchmarks that evaluate these abilities in isolation. To fill this void, we introduce Pix2Fact, a visual question-answering benchmark designed to assess expert-level visual perception and knowledge search. Pix2Fact comprises 1,000 high-resolution (4K+) images spanning eight scenarios. Its questions and answers are meticulously crafted by PhD-holding annotators from top global universities across diverse disciplines. Each question requires detailed visual grounding and the integration of external knowledge. Evaluating ten state-of-the-art VLMs, including proprietary models such as Gemini-3.1-Pro and GPT-5.4, we find that Pix2Fact poses a formidable challenge: the most advanced model (Gemini-3.1-Pro) achieves only 51.7% average accuracy, even with access to visual ground truth and search tools. Our analysis attributes this low accuracy to three factors, frequent visual grounding errors even with visual ground truth, shallow search harnessing, and VLM's inability to retrieve long-tail, unstructured local information. This striking gap exposes the limitations of current models in assisting humans with real-world scenarios that demand overwhelming visual comprehension. We believe Pix2Fact will serve as a critical benchmark to drive the next generation of language-vision agents that seamlessly integrate fine-grained perception with robust knowledge search.

15.
arXiv (CS.LG) 2026-06-16

Near-Optimal Regret for Distributed Adversarial Bandits: A Black-Box Approach

arXiv:2602.06404v2 Announce Type: replace Abstract: We study distributed adversarial bandits, where $N$ agents cooperate to minimize the global average loss while observing only their own local losses. We show that the minimax regret for this problem is $\tilde{\Theta}(\sqrt{(\rho^{-1/2}+K/N)T})$, where $T$ is the horizon, $K$ is the number of actions, and $\rho$ is the spectral gap of the communication matrix. Our algorithm, based on a novel black-box reduction to bandits with delayed feedback, requires agents to communicate only through gossip. It achieves an upper bound that significantly improves over the previous best bound $\tilde{O}(\rho^{-1/3}(KT)^{2/3})$ of Yi and Vojnovic (2023). We complement this result with a matching lower bound, showing that the problem's difficulty decomposes into a communication cost $\rho^{-1/4}\sqrt{T}$ and a bandit cost $\sqrt{KT/N}$. We further demonstrate the versatility of our approach by deriving first-order and best-of-both-worlds bounds in the distributed adversarial setting. Finally, we extend our framework to distributed linear bandits in $R^d$, obtaining a regret bound of $\tilde{O}(\sqrt{(\rho^{-1/2}+1/N)dT})$, achieved with only $O(d)$ communication cost per agent and per round via a volumetric spanner.

16.
arXiv (CS.CL) 2026-06-12

Influcoder: Distilling Decoders' Gradient Influence Rankings into an Encoder for Data Attribution

With the growth of LLMs' (Large Language Models) capabilities, there has been an increasing push to curate high quality datasets by filtering samples in the training data. In general, Data Attribution (DA) methods aim to estimate how individual samples in a training dataset can precondition a model to generate certain outputs. As an example, one might be interested in which samples in the data could be the source of toxic behavior after training the LLM. Many methods quantify this conditioning through the paradigm of influence functions. While methods of this family are effective in its function, they lack the necessary processing speed and storage compactness to be practically implemented on large datasets. We propose a method, Influcoder, as a quick and cost-effective approach to influence-based Data Attribution at scale.

17.
arXiv (CS.LG) 2026-06-16

Photon: Federated LLM Pre-Training

arXiv:2411.02908v2 Announce Type: replace Abstract: Scaling large language models (LLMs) demands extensive data and computing resources, which are traditionally constrained to data centers by the high-bandwidth requirements of distributed training. Low-bandwidth methods like federated learning (FL) could enable collaborative training of larger models across weakly-connected GPUs if they can effectively be used for pre-training. To achieve this, we introduce Photon, the first complete system for federated end-to-end LLM training, leveraging cross-silo FL for global-scale training with minimal communication overheads. Using Photon, we train the first federated family of decoder-only LLMs from scratch. We show that: (1) Photon can train model sizes up to 7B in a federated fashion while reaching an even better perplexity than centralized pre-training; (2) Photon model training time decreases with available compute, achieving a similar compute-time trade-off to centralized; and (3) Photon outperforms the wall-time of baseline distributed training methods by 35% via communicating 64x-512xless. Our proposal is robust to data heterogeneity and converges twice as fast as previous methods like DiLoCo. This surprising data efficiency stems from a unique approach combining small client batch sizes with extremely high learning rates, enabled by federated averaging's robustness to hyperparameters. Photon thus represents the first economical system for global internet-wide LLM pre-training.

18.
arXiv (math.PR) 2026-06-17

LP-Based Algorithms for Scheduling in a Quantum Switch

作者:

arXiv:2603.27812v2 Announce Type: replace-cross Abstract: We consider scheduling in a quantum switch with stochastic entanglement generation, finite quantum memories, and decoherence. The objective is to design a scheduling algorithm with polynomial-time computational complexity that stabilizes a nontrivial fraction of the capacity region. Scheduling in such a switch corresponds to finding a matching in a graph subject to additional constraints. We propose an LP-based policy, which finds a point in the matching polytope, which is further implemented using a randomized decomposition into matchings. The main challenge is that service over an edge is feasible only when entanglement is simultaneously available at both endpoint memories, so the effective service rates depend on the steady-state availability induced by the scheduling rule. To address this, we introduce a single-node reference Markov chain and derive lower bounds on achievable service rates in terms of the steady-state nonemptiness probabilities. We then use a Lyapunov drift argument to show that, whenever the request arrival rates lie within the resulting throughput region, the proposed algorithm stabilizes the request queues. We further analyze how the achievable throughput depends on entanglement generation rates, decoherence probabilities, and buffer sizes, and show that the throughput lower bound converges exponentially fast to its infinite-buffer limit as the memory size increases. Numerical results illustrate that the guaranteed throughput fraction is substantial for parameter regimes relevant to near-term quantum networking systems.

19.
arXiv (CS.CV) 2026-06-16

Leptomeningeal Collateral Detection on DSA via Vessel-Graph Neural Networks

Leptomeningeal collaterals (LMCs) are an important prognostic factor in acute ischemic stroke. Existing automated methods rely on CT angiography (CTA), but individual LMCs are often too small to be resolved on CTA, limiting these methods to coarse collateral scoring. Digital subtraction angiography (DSA) visualizes individual collaterals at superior resolution, yet current assessment remains subjective, relying on manual grading scales that suffer from poor inter-rater agreement. We present a framework that formulates collateral detection as the classification of individual vessel segments on a graph derived from DSA. A hybrid graph-pixel architecture combines a topology-aware graph branch with a dense pixel branch, fused in a shared node-probability space. In a five-fold cross-validation setting, the fused model achieves a PR-AUC of 0.434, outperforming the graph-only (0.403) and pixel-only (0.362) baselines. To our knowledge, this is the first method to enable the individualization of LMCs in DSA, allowing for precise per-vessel quantitative assessment. This integration shifts DSA assessment toward objective evaluation, supporting future biomarker and pattern discovery for individual LMCs.

20.
PLOS Medicine 2026-05-06

Point-of-care early infant HIV diagnosis at birth in a pragmatic cluster-randomized trial in Mozambique and Tanzania: A comparative cost and cost-effectiveness study

by Kira Elsbernd, Issa Sabi, Ilesh V. Jani, Chishamiso Mudenyanga, Siriel Boniface, Arlete Mahumane, Joaquim Lequechane, Falume Chale, Bindiya Meggi, Kassia Pereira, Raphael Edom, Anange F. Lwilla, W. Chris Buck, Nyanda Elias Ntinyinya, Michael Hoelscher, Till Baernighausen, Arne Kroidl, Stefan Kohler, the LIFE Study Consortium Background Timely access to early infant diagnosis (EID) is crucial for newborns with HIV, as late diagnosis can delay lifesaving antiretroviral treatment (ART). We assessed the comparative cost and cost-effectiveness of integrating point-of-care EID at birth into routine care in primary healthcare settings. Methods and findings This pre-specified secondary analysis was nested in the cluster-randomized LIFE study conducted at 28 primary healthcare facilities in Mozambique and Tanzania from October 2019 to September 2021. We estimated the health system cost of point-of-care birth plus 4–8-week HIV testing (very early infant diagnosis; VEID) compared to standard-of-care (SoC) testing at 4–8 weeks only, both with immediate ART initiation. We assessed the cost-effectiveness of VEID relative to SoC with respect to ART initiation within one week of life using Bayesian hierarchical models. As this is an intermediate outcome, incremental cost-effectiveness ratios (ICERs) cannot be directly compared to available life-year-based cost-effectiveness thresholds. To contextualize results, we derived the minimum life-years gained per early ART initiation required for VEID to meet standard thresholds in a break-even analysis.VEID was associated with a higher cost and resulted in earlier ART initiation than SoC in both countries. In Mozambique, VEID increased the proportion of infants initiating ART within one week of life by 90.0 (95% CrI [67.5, 98.5]) percentage points at an incremental cost of $2,632 (95% CrI [$2,249, $3,062]) per infant with HIV. In Tanzania, VEID increased early ART initiation by 59.9 (95% CrI [20.9, 89.5]) percentage points at an incremental cost of $6,263 (95% CrI [$5,394, $7,243]) per infant with HIV. The ICER was $2,924 and $10,458 in Mozambique and Tanzania, respectively and was sensitive to intrauterine transmission rate. These findings were limited by the lack of long-term health outcome data and reliance on an intermediate outcome. Based on the break-even analysis, we estimated that VEID would need to yield 6–32 life-years gained per additional early ART initiation to meet standard thresholds. Conclusions Adding birth testing improved early ART initiation but was unlikely to be cost-effective relative to standard thresholds given current prices, vertical transmission rates, and knowledge of long-term health benefits. Cost-effectiveness could be achieved at current costs if early ART translates to substantial long-term health benefits or if targeted to infants at high risk of vertical transmission.

21.
medRxiv (Medicine) 2026-06-15

ECHOCARDIOGRAPHY ABNORMALITIES IN PREECLAMPSIA WITH SEVERE FEATURES.

Purpose To determine the frequency of echocardiographic abnormalities in women with preeclampsia with severe features. To describe the spectrum and types of echocardiographic abnormalities associated with preeclampsia with severe features. Method This is a Prospective observational study conducted in Vani Vilas hospital attached to Bangalore Medical College and Research Institute, Bangalore from January 2023 to December 2025. 560 pregnant women diagnosed with severe preeclampsia(SPE) were included in the study. Chronic hypertension without superimposed preeclampsia, underlying cardiac diseases and previous history of peripartum cardiomyopathy were excluded from the study. Transthoracic echocardiography-TTE (2D ECHO) was done to evaluate cardiac structure and function. Echocardiographic abnormalities identified during the study were documented and analysed using descriptive statistical methods. Results Abnormalities in ECHO was noted in 23.03%. A unique finding was the documentation of elevated pulmonary artery systolic pressures (PASP) suggestive of Pulmonary Hypertension (PH) (PASP >35 mm HG) among 20.25% of the participants. It was also the commonest abnormality on ECHO. Mild PH was the commonest (15.71%), moderate PH was seen in 3.92% and severe PH in 0.71% of cases. Next most frequent abnormality was moderate to severe valvular regurgitation (10%), followed by left ventricular hypertrophy (5.53%). Diastolic dysfunction (DD) was seen in 3.92%, systolic dysfunction(SD) in 3.57%, chamber dilatation in 3.57% and LV global hypokinesia in 3.03% cases of SPE Conclusion Preeclampsia with severe features (SPE) is associated with 23.03% abnormalities on echocardiography. SPE is associated with systolic dysfunction, diastolic dysfunction, chamber dilatation, valvular regurgitation, left ventricular hypertrophy and pulmonary hypertension.

22.
medRxiv (Medicine) 2026-06-10

Towards the Virtual Amyotrophic Lateral Sclerosis Patient: Inferring Cortical Excitability through Whole-Brain Dynamical Modeling

Amyotrophic lateral sclerosis (ALS) is increasingly recognized as a multisystem neurodegenerative disorder in which motor-neuron degeneration is accompanied by widespread alterations in cortical dynamics. Among its most reproducible neurophysiological signatures is cortical hyperexcitability, yet how this local excitability imbalance shapes distributed whole-brain activity remains poorly understood. Here, we combined source-reconstructed resting-state MEG data, tractography-informed whole-brain modeling, and simulation-based inference to investigate whether ALS-related alterations in large-scale brain dynamics can be mechanistically explained by changes in cortical excitability. First, we characterized empirical brain dynamics using complementary features spanning regional activity amplitude and variability, functional connectivity, and avalanche-based metrics. These analyses revealed significant alterations in ALS patients relative to healthy controls, as well as associations with clinical impairment and disease staging. To mechanistically interpret these changes, we employed a reduced Wong-Wang whole-brain model in which local recurrent excitation modulates emergent large-scale neural dynamics. Simulations showed that increasing excitability systematically reproduced the empirical dynamical signatures observed in ALS. We then applied a simulation-based inference framework to estimate latent excitability parameters directly from empirical observations. Whole-brain model inversion revealed increased excitability in ALS patients compared with controls. The recovered excitability parameter was associated with disease staging, supporting its clinical relevance as a model-derived descriptor of ALS progression. Finally, by extending the model to estimate frontal and non-frontal excitability separately, we found that ALS-related alterations were predominantly associated with increased frontal excitability, whereas non-frontal regions appeared comparatively less affected. The recovered parameters related to disease staging. Together, these findings provide a mechanistic framework linking altered large-scale brain dynamics in ALS to selective cortical hyperexcitability, explaining how local excitability changes can give rise to global network reorganization. More broadly, they show how computational model inversion can recover latent multiscale pathophysiological processes from empirical neural recordings, offering a non-perturbative alternative to complex experimental paradigms typically required to causally probe local-to-global mechanisms.

23.
arXiv (CS.CL) 2026-06-11

Goal-Autopilot: A Verifiable Anti-Fabrication Firewall for Unattended Long-Horizon Agents

作者:

Long-horizon LLM agents are not trusted to run unattended: with no human watching, they confidently report success they never verified. We treat honesty – bounding what an agent may claim at termination – as a first-class metric for unattended autonomy, distinct from capability. We present Autopilot, an execution model that makes silent fabricated success structurally impossible rather than merely rarer. Autopilot externalizes all working state into a durable, gated finite-state machine that a scheduler advances one stateless tick at a time; a hard floor forbids any terminal "done" claim whose falsifiable gate did not actually execute and pass. We prove a No-False-Success theorem – under gate soundness, floor enforcement, and plan coverage, termination implies the goal holds – whose only trust points are empirically measurable, and show the worst case degrades to an honest stall, never a fabricated success. Because each tick rehydrates only the state machine, per-step context cost is constant in the horizon. Across a 3,150-cell paired corpus (70 tasks $\times$ 3 systems $\times$ 3 models $\times$ 5 seeds, including 50 SWE-bench Lite tasks across 11 OSS repos), Autopilot fabricates on 0.95% of cells [95% CI 0.38–1.62] while Reflexion and StateFlow baselines fabricate on 8.10% [6.48–9.81] and 25.05% [22.48–27.62] respectively. The headline contrast lives in the hard regime: on SWE-bench Lite, the firewall reduces fabrication from 33.7% (StateFlow) to 0.67%, a paired difference of $-33.07$ pp [95% CI $-36.53, -29.73$]. The mechanism is the gate, not the model: all ten Autopilot fabrications come from the strongest model, while two weaker mid-tier models never fabricate across 700 paired cells. The firewall trades coverage for honesty by design – an honest stall is recoverable; a confident wrong output shipped downstream is not.

24.
medRxiv (Medicine) 2026-06-22

Regional Service-System Conditions Associated with Facility-Linked Home-Based Specialist Care in Japan: A Claims-Based Ecological Study of Home Dialysis

Background Complex chronic care is increasingly delivered in patients' homes while remaining linked to specialist facilities for training, monitoring, and backup care. Home dialysis provides a useful case because peritoneal dialysis (PD) and home hemodialysis (HHD) share a home-facility delivery structure but differ in technical and operational requirements. This study examined regional service-system conditions associated with the presence and scale of PD and HHD in Japan. Methods This ecological study used publicly available claims, administrative, census, and geospatial data harmonized to 334 Secondary Medical Areas. Regional indicators were organized into four domains: dialysis service delivery, implementation support for home-based care, hospital backup capacity, and living and sociodemographic context. Diffusion was examined using claims-based indicators of regional presence and post-presence scale, analyzed separately for PD and HHD with Firth penalized logistic regression and zero-truncated negative binomial regression, respectively. Results PD was observed in 271 regions and HHD in 109. Patterns of associated regional conditions differed by modality and stage. PD was associated mainly with existing dialysis-service organization, whereas HHD was associated with broader regional supports, including home-care delivery, living infrastructure, transition support, and hospital-system indicators. Conditions associated with presence differed from those associated with scale. Cross-modality associations suggested that shared regional factors may shape the distribution of both modalities. Conclusions Regional conditions for home dialysis diffusion in Japan differed by modality and stage. PD was linked mainly to existing dialysis-service organization, whereas HHD was linked to multi-domain regional support for technically demanding home treatment. Under standardized reimbursement, local service-system capacity may remain important for modality- and stage-specific diffusion of home dialysis.

25.
arXiv (CS.LG) 2026-06-11

The ASE-LSE Disagreement Landscape: An End-to-End Characterisation of Extremes and Structural Drivers

arXiv:2605.22346v3 Announce Type: replace-cross Abstract: Two of the most widely used methods for analysing graph data, Adjacency Spectral Embedding and Laplacian Spectral Embedding, often produce different results when applied to the same graph. Yet the structural reasons behind this disagreement remain incompletely understood. This paper provides an end-to-end account of ASE-LSE latent subspace disagreement. We first prove that the two methods produce identical latent subspaces for every embedding dimension whenever the Laplacian is a scalar multiple of the adjacency matrix, and show that this scalar relationship holds if and only if the graph is either regular or bipartite biregular. This anchor result identifies a sufficient condition for perfect agreement that pins down the floor of the disagreement spectrum and supplies the baseline for the perturbation analysis. We then prove that no maximal-disagreement graph or family of graphs exists: the disagreement is always strictly below its theoretical ceiling, and we exhibit a witness family demonstrating that no finite maximum is attainable, so the disagreement landscape has no maximiser. With both endpoints established, we derive a Regularity Departure Bound whose two terms isolate degree heterogeneity and eigengap as the primary structural factors influencing disagreement in the middle regime. Empirical validation across thousands of simulated graphs confirms the mechanisms predicted by the bound: heterogeneity pushes disagreement up, eigengap suppresses it, and their joint ratio emerges as a unified predictor of ASE-LSE disagreement, suggesting when the two embeddings can be treated as interchangeable and when they cannot.